Plaster Jacket Research Articles

Using the methyl cellulose poultice method to remove plaster and burlap - A case study on Triceratops bone

The dinosaur collection at the Natural History Museum, London (NHM) includes a Triceratops skull (NHMUK PV R 3886), purchased from Charles Sternberg in 1909. While most of the skull is on public display in the Dinosaurs gallery, two large sections of the frill (the squamosal bones) had been replicated for the display and the originals left in storage. With much of the fossil bone obscured by plaster of Paris, the original frill sections were deemed of limited use to science in their current form. A work request was received to strip away as much artificial material as possible to determine the extent of the original fossil material. An air scribe fitted with a chisel stylus proved initially effective, but soon revealed an additional obstacle – layers of hessian underneath. The methyl cellulose poultice method was used to swell the hessian, aiding softening of the plaster, and allowing layers to be torn off in strips. The fine layer of plaster remaining on the bone was removed, where possible, with a Split-V ultrasonic tool. This sequence of treatments can be utilised at minimal risk to specimens in similar situations when a hessian and plaster jacket has been applied but a separator layer has been omitted.

Comparative study between operative and conservative treatment in cases of spinal cord injury: An analytical, case control and prospective study in a tertiary care hospital of Bihar

Introduction: Spinal cord injury (SCI) following trauma is a functional, psychological and socioeconomic disorder, results in serious secondary medical complications with increased morbidity and mortality. In most of the cases it leads to increased hospitalization, loss of employment and decreased quality of life. Aims & Objectives: To observe and compare the outcome of conservative and operative methods of treatment in patients of traumatic paraplegia due to spinal cord injury. Materials and Methods: This was an analytical, case control, prospective study. Twenty-one consecutive patients of spinal cord and spinal column injuries of age between 10 to 60 years and both the gender were included. Using Thoracolumbar Injury Classification and Severity Score (TLISS) they were divided into conservative group (n=13, TLISS score ?3 and 4) and operative group (n=8, TLISS score ?5). Follow up was done on 3rd week, 12th week, 24th week and 36th weeks of treatment. Results: Most of the patients in this study were in 31-40 years, male, from rural area, injured due to fall from height. Out of 13 patients treated conservatively, 7 had excellent, 4 had good, and 2 had bad outcome according to clinical and radiological findings at the end of follow up months. There was no significant difference in sensory control, motor control, bladder/bowel voluntary control and complications among patients undergone conservative and operative treatment. But the radiological findings for deformity correction was significantly higher among patients undergone operative treatment with respect to conservative treatment. Conclusions: In this study operative management of spinal cord injury was more efficacious, more compliant but had similar co-morbidity with respect to conservative management. But on the basis of treatment cost and complications conservative management is mostly preferred in rural areas. Keywords: Traumatic paraplegia, Thoracolumbar injury severity score (TLISS), Plaster jacket

Collections Support Services (CSS) - 25 Years of Improving Access and Care to our Nation’s Collections

Originally formed in the early 1980s as the Move Crew to move museum collections to the newly opened state of the art Smithsonian Institution’s Museum Support Center, Collections Support Services has evolved into a team of highly skilled museum professionals recognized as trusted experts, innovators, project managers, and problem solvers in all aspects of collections stewardship. We have packed, moved, and stored MILLIONS of objects across Smithsonian museums including the National Museum of Natural History and several of our art museums; the Freer Sackler Gallery, Hirshhorn Museum and Sculpture Garden, and National Museum of African Art. Our vast experience with Natural History collections has been with objects ranging from microscopic invertebrates, fragile bird eggs, 40’ war canoes, whale skulls, giant squids and EVERYTHING in between! Many of these collections came from overcrowded and dusty attics, basements, and warehouses prone to flooding, pest infestation, and poor climate control. We have spent the last 25 years moving these collections into our climate controlled storage pods furnished with new metal cabinets designed for long term preservation. Some of the unique packing and transportation methods we will highlight in this presentation are “airbags” that encompass fragile bird skeletons and uniform shipping containers made of ethafoam planks and old wooden drawers. In addition, we have designed and constructed aluminum pallets for oversized collections, specialized elephant skull pallets, and plaster jackets for paleo fossil specimens. These storage solutions have greatly improved access to collections by allowing researchers to study specimens with minimal handling necessary. This presentation will specifically demonstrate these and other dramatic improvements that we have made as well as highlight innovative solutions we developed to safely transport, store, and provide better access to our Natural History collections for future generations.

Art in science: The artist's view of orthopaedic surgeries.

Art in science: The artist's view of orthopaedic surgeries.

Reviving the Dinosaur: Virtual Reconstruction and Three-dimensional Printing of a Dinosaur Vertebra

To demonstrate the feasibility of using computed tomography (CT) to confirm the identity of an unprepared fossil and to use the CT dataset to separate the fossilized bone from its surrounding sediment matrix and produce a three-dimensional (3D) print. The examined object was a plaster jacket containing an unprepared fossil. CT was performed with a 320-section multidetector unit. A marching cube-based method was used to transform the voxel CT dataset into triangle-based, editable geometry. Then, a comprehensive postprocessing step was performed to isolate the geometry of the vertebra from its surrounding fossilized matrix. Finally, the resulting polygon mesh describing only the vertebra was used for a physical 3D reconstruction by using a selective laser sintering machine. The CT examination provided enough data to assign the fossil to the genus Plateosaurus. In addition, much valuable information about the fossil has been gained-in particular the visualization of multiple fractures and the destruction of the anterior rim of the vertebral body. Finally, the results show that the 3D print generated, including the fractures and the anterior destruction, may be considered an accurate copy of the bone with the unprepared fossil. The authors demonstrated the feasibility and potential utility of combining CT with 3D printing, providing a nondestructive method to future paleontologists.

Controversial Issue Session: Brace treatment in infantile scoliosis: benefits

Material and methods In 1965, Cotrel and Morel describing the EDF plaster jacket technique stated that “in young children, it should be feasible not only to prevent further progression but above all to use the child’s growth to regress structural vertebral and thoracic deformities”. Before the child start walking, we use a plaster shell in bending correction. After walking, an underarm plaster cast with a large anterior opening, and the modified Milwaukee brace with polyethylene bars and cervical collar without hyoid support is the only brace that can manage curves in the top part of the spine. It is also the only brace that can avoid a hypoplastic thorax.

Controversial Issue Session: Brace treatment in infantile scoliosis: brace treatment problems

Orthotic treatment of infantile scoliosis represents a challenge: 1. Most of them are progressive 2. Different etiologies 3. Associated diseases 4. Smaller size anatomy 5. Immature rib cage Types: 1. Braces • Do not provide immediate correction • Treatment aimed to “hold” the spine and prevent further progression • Risk of chest deformity in case of braces constricting the thorax • Literature does not support the efficacy of braces in the treatment of infantile scoliosis • Poor compliance (Parents) 2. Casts/Braces under traction • Provide correction. Sometimes scoliosis can be reversed by early treatment with serial corrective plaster jackets in children with mild curves and at an early age (under age two) • Immature rib cage often deforms before significant correction is transmitted to the spine • May provoke skin problems • They may reduce the deformity but not reverse it • Main goal: delay surgery as much as possible • Braces under traction diminish cast complications with the same efficacy in the long term

Central Nervous System Aspergillosis causing Spinal Cord Compression

Central nervous system (CNS) aspergillosis is a rare and uniformly fatal complication of disseminated disease, involving the cerebral hemispheres and cerebellum in the majority of cases. It is a ubiquitous mold and refers to a group of diseases caused by monomorphic mycelial fungi of the genus Aspergillosis fumigatus. Outbreaks of invasive aspergillosis are a problem in immunocompromized persons after they are exposed to air-borne spores.1 Aspergillosis causing spinal cord compression due to epidural abscess formation and hypertrophic pachymeningitis is a rare entity, thus such a case is presented herewith. A 16-yrs old male was diagnosed in early childhood of chronic granulomatous disease with recurrent abscess formation of lymph nodes and pneumonias. He was on regular daily trimethoprim-sulphamethaxazole prophylaxis. At twelve years of age, he developed osteomyelitis of the right 10th rib and underwent resection and the necrotic material grew Aspergillosis fumigatus. He was treated with amphotericin infusion for three weeks followed by itraconazole for a month. Three years later, he developed progressive weakness of both legs with difficulty in walking. Clinical examination revealed that the patient had spastic paraperesis at a D10 spinal level with spinal tenderness at D7-D9. There was no obvious swelling in the paraspinal region at that time. The bladder and bowel functions were intact although he had little hesitancy of micturation. The MRI of the thoracic spine revealed paravertebral soft tissue density in the lower dorsal region D6-D8 with liquefaction in the centre consistent with abscess. There was also a moth-eaten appearance and destruction of D7 vertebral body, (Fig. 1). Orthopedician was consulted, the abscess was drained followed by laminectomy of D6 to D11 vertebrae and decompression was performed. The abscess material grew Aspergillosis fumigatus. He was started on high-dose amphotericin B for 30 days. Later, itraconazole was given for a month. He also received broad-spectrum antibiotics, namely imipenum, ciprofloaxacin and amikacin during the postoperative period. He developed thrombophlebitis at the injection site, and later episodes of hypokalemia which were managed by potassium upplements. He was then put on plaster jacket and discharged. On reviewing him after a month, he was paraplegic with Grade 2/5 power in legs and had urinary and bowel involvement. Figure 1 MRI dorsal spine -T1 weighted sagittal contrast- showing extradural aspergillosis compressing spinal cord D6-8 with collapse of D7 vert. body There was also abscess formation at the operation site with sinus, discharging pus. The wound swab grew aspergillosis and he was given a six-week course of amphotericin B and itraconazole. Bone marrow transplantation was planned but he developed persistent fever and the blood culture revealed Acenobacter. Despite treatment with many antibiotics, the patient died of septicemia. CNS aspergillosis primarily affects adults. It occurs as a sino-cranial infection in all the reported cases and spinal cord involvement is either due to contiguous spread from the lungs or affecting cord prior to lungs indirectly by hematogenous route.2 Recently, there has been some increase in the incidence of invasive aspergillosis in the acquired immunocompromized individuals.3 Thus disseminated aspergillosis is a devastating disease in the immunocompromized patients and the ultimate prognosis is bad. The neurological disability was worse despite aggressive management.

Conservative treatment of spinal injuries yesterday and today

Since 60 years fractures of the spine are reduced by longitudinal traction and hyperlordosis and then immobilized in a plaster jacket followed by an intensive exercise programme. This type of treatment was originated by Davis, Watson-Johnes and Lorenz Böhler. Inspite of the increase of operative stabilizations this method of treatment is still valid.

Growth as a corrective force in the early treatment of progressive infantile scoliosis

This prospective study of 136 children with progressive infantile scoliosis treated under the age of four years, and followed up for nine years, shows that the scoliosis can be reversed by harnessing the vigorous growth of the infant to early treatment by serial corrective plaster jackets. In 94 children (group 1), who were referred and treated in the early stages of progression, at a mean age of one year seven months (6 to 48 months) and with a mean Cobb angle of 32 degrees (11 degrees to 65 degrees), the scoliosis resolved by a mean age of three years and six months. They needed no further treatment and went on to lead a normal life. At the last follow-up, their mean age was 11 years and two months (1 year 10 months to 25 years 2 months), 23 (24.5%) were at Risser stages 4 and 5 and 13 girls were post-menarchal. In 42 children (group 2), who were referred late at a mean age of two years and six months (11 to 48 months) and with a mean Cobb angle of 52 degrees (23 degrees to 92 degrees), treatment could only reduce but not reverse the deformity. At the last follow-up, at a mean age of ten years and four months (1 year 9 months to 22 years 1 month), eight children (19%) were at Risser stages 4 and 5 and five girls were post-menarchal. Fifteen children (35.7%) had undergone spinal fusion, as may all the rest eventually.

The Fossil vertebrates of Florida

Illustrated with hundreds of photographs and drawings, this authoritative yet readable book describes the fossil vertebrates found in Florida - many unique to the state - and summarizes more than 100 years of paleontological discoveries and research. It bridges the sometimes disconnected worlds of the professional paleontologist and the avocational collector and hobbyist. Florida has the richest vertebrate fossil record of any state east of the Mississippi, extending back 45 million years. Beginning with an introduction to vertebrate anatomy, Richard Hulbert describes the geological history of the state and the history of vertebrate life in it. He then addresses such questions as what animals lived in Florida, how they are related to one another and to living animals, when they first appeared and when many of them became extinct, what they ate, and what they tell us about past environments. All types of vertebrates are covered, including sharks and other fish, amphibians, reptiles, birds, and mammals. In addition to exceptionally detailed illustrations (many published for the first time), the book includes a comprehensive list of every verified fossil species ever collected in Florida. Based on the popular Plaster Jacket series of pamphlets written by renowned natural scientists and published by the Florida Paleontological Society, The Fossil Vertebrates of Florida brings information from the last 30 years into an up-to-date, greatly expanded, cohesive book form.

Bibliography and scientific name index to amphibians and reptiles in the Bulletin of the Florida Museum of Natural History, volumes 1-39, 1945-1996 and the plaster jacket, numbers 1-46, 1966-1984

Bibliography and scientific name index to amphibians and reptiles in the Bulletin of the Florida Museum of Natural History, volumes 1-39, 1945-1996 and the plaster jacket, numbers 1-46, 1966-1984

A 15-year assessment of controlled trials of the management of tuberculosis of the spine in Korea and Hong Kong

The final results up to 15 years are reported of clinical trials of the management of tuberculosis of the spine in Korea and Hong Kong. In Korea, 350 patients with active spinal tuberculosis were randomised to ambulatory chemotherapy or bed rest in hospital (in Masan) or a plaster-of-Paris jacket for nine months (in Pusan). Patients in both centres were also randomised to either PAS plus isoniazid for 18 months or to the same drugs plus streptomycin for the first three months. In Hong Kong, all 150 patients were treated with the three-drug regime and randomised to either radical excision of the spinal lesion with bone graft or open debridement. On average, the disease was more extensive in Korea, but at 15 years (or 13 or 14 years in a proportion of the patients in Korea) the great majority of patients in both countries achieved a favourable status, no evidence of CNS involvement, no radiological evidence of disease, no sinus or clinically evident abscess, and no restriction of normal physical activity. Most patients had already achieved a favourable status much earlier. The earlier results of these trials are confirmed by the long-term follow-up with no late relapse or late-onset paraplegia. The results of chemotherapy on an outpatient basis were not improved by bed rest or a plaster jacket and the only advantage of the radical operation was less late deformity compared with debridement. A second series of studies has shown that short-course regimes based on isoniazid and rifampicin are as effective as the 18-month regimes: ambulatory chemotherapy with these regimes should now be the main management of uncomplicated spinal tuberculosis.

Radiological and functional outcome after anterior lumbar interbody spinal fusion.

Outcome after anterior spinal fusion has mainly been studied radiologically and reported fusion rates vary greatly. The aim of this study was to investigate radiological and long-term clinical outcome. The study comprised 120 consecutive patients, operated on during the period 1979-1987, with single-or two-level anterior interbody spinal fusion due to disc degeneration or isthmic spondylolisthesis with lumbar instability. In 64 patients a supplemental facet joint fusion was performed. Clinical outcome was evaluated 5-13 years after surgery using the patient-administered Dallas Pain Questionnaire (DPQ). Radiological outcome was determined on the basis of radiographs taken at a 2-year follow-up assessed by independent observers. The radiological follow-up rate was 98%. Complete fusion was found in 52%, questionable fusion in 24%, and definitive pseudoarthrosis in 24% of patients. Radiological results were poor in patients who had undergone previous spinal surgery (P < 0.05) and in those with two-level fusion (P < 0.05). The DPQ reply rate was 80%. Sixty-six patients claimed improvement in all functional groups. Patients with complete or questionable union had significantly better results than did those with non-union (P < 0.01). Poorer functional outcome was found in patients who had undergone previous spinal surgery (P < 0.01) or fusion at the L4/L5 level (P < 0.05), in those who had responded poorly to the preoperative test brace (P < 0.05), and in those above 45 years old at the time of surgery (P < 0.05). Radiological and functional outcome did not vary according to whether patients were treated postoperatively with a plaster jacket or with facet screw fixation. The study demonstrated a functional success rate of approximately 66% following anterior lumbar spinal fusion after a mean follow-up of 8 years. There was a clear tendency for poorer prognosis for patients who had undergone previous spinal surgery, those aged above 45 years, those operated at the L4/L5 level and those who had responded poorly to the preoperative test brace. DPQ scores correlated well with radiological outcome.

Peri-operative hypoxaemia in children undergoing application of a plaster jacket for scoliosis.

Twenty children (six female), median age 24 months (range 12-156) who presented for application of a plaster jacket for scoliosis were studied pre-operatively with pulse oximetry overnight and on the first postoperative night. Pre-operatively the median (range) arterial oxygen saturation was 97 (95-98)%, although eight children had short episodes of desaturation to < 90%. Postoperatively the median saturation was unchanged, and nine children had short episodes of desaturation. Neither the presence of episodes of desaturation pre-operatively, nor the median or lowest saturation recorded were predictors of postoperative median saturation or the presence of episodes of desaturation. Despite the presumed reduction in chest wall compliance, the application of a plaster jacket for scoliosis in these young children was not associated with a significant change in their oxygenation.

Magnetic polarity stratigraphy and correlation of the Leisey Shell Pits, Hillsborough County, Florida

Oriented paleomagnetic samples were collected from plaster jackets containing fossils, in situ bivalves, and surrounding matrix from the Leisey Shell Pit. Analysis in the paleomagnetic laboratory indicates that the magnetization is probably carried in fine-grained magnetite. After both alternating field and thermal demagnetization, all of the five sites sampled are interpreted to be of reversed polarity fo6r the local section at Leisey. In conjunction with the stage of evolution of the fossil mammals and interbedded Sr isotopic data, the Bermont Formation in the area of Leisey correlates to the late Matuyama Reversed Chron between about 1.66 and 1.4 Ma.

Failed back surgery syndrome. Part II: Surgical techniques, implant choice, and operative results in 171 patients with instability of the lumbar spine.

171 patients with an instability-related failed back surgery syndrome underwent internal fixation. The operative indication was based on specific diagnostic procedures such as anaesthesia of articular nerves and the trial external immobilization in a plaster jacket. Taking account of the different types of hypermobility/instability of the lumbar spine, different spinal implants were used leading to excellent, good, satisfactory, moderate and poor results in 87 (53%), 42 (26%), 23 (14%), 9 (6%) and 2 (1%) patients, respectively.

Tuberculous spondylitis and intermittent chemotherapy in childhood.

The general characteristics and treatment of childhood tuberculous spondylitis are reviewed. Most of the patients (79 per cent) were under 5 years old with girls being in greater number. Twenty-six patients used classical antituberculous chemotherapy and five were given intermittent chemotherapy. There was no significant difference in the mean period of inactivation of the disease (2.8 v. 2.9 months) or in post-treatment angle of kyphosis (33 degrees v. 37.6 degrees) between the classical and intermittent chemotherapy groups. In addition to drug therapy, plaster jacket and immobilization were adequate in four children whereas 27 underwent surgery with only two requiring radical operations. In children with tuberculous spondylitis, intermittent drug treatment is a good alternative due to effectiveness and convenience of use and radical surgery should be reserved for selected cases.

Failed back surgery syndrome. Part I: Analysis of the clinical presentation and results of testing procedures for instability of the lumbar spine in 171 patients.

The clinical presentation and diagnostic approach in 171 patients with a failed back surgery syndrome is presented and analyzed with respect to the mode of the primary discectomy-approach and type of resulting instability as well as results of internal fixation. The clinical picture and physical signs are quite distinct but the indication for internal fixation is only obvious in the presence of positive results of additional testing procedures such as the anaesthesia of articular nerves and trial immobilisation in a plaster jacket. Different types of instability of the lumbar spine occur in relation to the mode of the primary and/or secondary discectomy-approach(es). By application of this diagnostic protocol excellent, good, satisfactory, moderate and poor results were obtained in 87 (53%), 42 (26%), 23 (14%), 9 (6%), and 2 (1%) patients, respectively (final evaluation was possible in 163 patients).

Diagnostic approach in instability and irritative state of a ?lumbar motion segment? following disc surgery?Failed back surgery syndrome

A diagnostic protocol for patients with suspected instability and irritative state of a "lumbar motion segment" following lumbar disc surgery is presented and the results of internal fixation are analyzed. In this group of patients the clinical picture and physical signs may be quite distinct and suggestive of instability and irritation of a "lumbar motion segment", however, in isolation, they do not allow to decide upon surgery. Radiological studies favour a decision for surgery only in cases with an obvious instability of a "motion segment". Anaesthethizing the articular nerves permits localization of the irritable segment and non-surgical therapeutic decisions (thermocoagulation) can only be taken in cases of an isolated facet-syndrome when instability has been ruled out. The trial plaster jacket holds the most important position with respect to the indication for internal fixation as demonstrated by the conformity of the results of the plaster jacket and the results of surgery. After internal stabilization excellent, good, satisfactory and moderate results were obtained in 20, 3, 1 and 1 patients, respectively.